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K$ $ <br /> IF <br /> t <br /> STATE OF CAUFORNIA <br /> 5 35>� <br /> ORIGINAL THE RESOURCES AISE 14CY Do not fill in <br /> File with DWR DEPARTMENT OF WATER RESOURCES <br /> WATER WELL DRILLERS REPORT N0. 336910A. 15 <br /> Jotice of Intent No State Well Na <br /> Local Permit No or Date Other Well No. <br /> (1) OWtiER Mame KEAl2Nf Y-KPF (12) WELL LOG Total depth 72.5/ft Campleteddepthl�_UA <br /> ft <br /> Address —1-624 1 n Avenug from ft to ft. Formation(Desenbe by color character size or material) <br /> City 5tockton, California �� ZIP 52D - See information attached <br /> (2) LOCATION OF WELL (See Instructions) KS—d - shallow monitor- well KS-4 <br /> County San Joaquin Owner s Well Number KS-5 - shallow monitor well KS-5 <br /> Well address if different From above saw as above — <br /> Towttship 2 North Rartge 6 East Section 35 — <br /> Distance from cittM roads, railroads, fences,etc- — <br /> See figure attached - <br /> (3) TYPE OF WORK <br /> New Well & Deepening ❑ — <br /> Reconstruchon ❑ <br /> Reconditioning ❑ <br /> Honzontal Well D <br /> 1 � <br /> Destruction ❑ (Describe — <br /> destruction materials and pro- <br /> cedures in Item 12) <br /> (4) PROPOSED US <br /> Domestic "J <br /> Irrigation <br />• Industrial ��� ❑ _ r r l <br /> Test Well \ \ ❑ ^ <br /> Munict ❑ <br /> WELL LOCATION SKETCH 0>4errbe1 <br /> y <br /> (5) EQUIPMENT CIIAVtL MCK <br /> RotaryI Reverse <br /> Cable ❑ Air ❑ es re f6ore atf i r1�•� `1 —/ Note: Shallow monitor well KS--A !d <br /> Other © Riicked� tar d - , - - drilled and completed 4/13/89 <br /> r ra -` - Shallow monitor well KS--5 drilled <br /> (7) C*,SINC INSTALLED- (81 PERFBRITI I' ^ ` — and completed 4/21/89 <br /> Steel ❑ Plaaw ❑ Ty off on or size of Q W <br /> From T' I Cage or \ 66i Id<' � Ot — <br /> ft f I Wall 1`4 L�: -,size <br /> ttac .4 ktt <br /> (9) WELL SEAL v - <br /> Was surfaco sanitary seal Provrdeda Yes [X No ❑ If yes,to dept, ttached It <br /> Were strata sealer}against podutwn? Yes ❑ No ❑ Interval attached ft — <br /> Methodofwahng tremie Work start �ii above 14 Completed I9 <br /> (10) WATER LEVEL` WELL DRILLERS STATEMENT <br /> Depth of first water d mown �lnknown ft <br /> Standing level after well coni letum 63 feet ft eesit well tuns ledge and bele.f nlled under1 uresluttura unit Ehs report is true to t!t¢ <br /> g P best of my knotuledi, <br /> (11) WELL TESTS Signed �:&ft- <br /> st in <br /> � vvefl-HrtN;rf 'ICAO kTsT" <br /> WAS WPiI test Yes ED No i� [f yens by wlinrn? <br /> _,pe of test Nmp k A Bade- C] 'uE�if#A© NAXIE HARG I S + ASSOCIATES INC.- <br /> Depth to wate�a�t start of test _ ft At end of test R/ ft 2222 S.'"o gd—ti-lP�Td FTfFd 2f0Tted) <br /> Drscharl{e�I�r� qal/m,naFter N/A hours Water temperature N A address UIt ISVi Ul t' 'tt1l <br /> Chemie+l an.Jvsis made? Yes X1 No ❑ If yes,by whoini�lar 7 S E SQ tty M-es a, Ale 1 ZOn a ZIP 85202 <br /> Wag 60drre log made Yes ❑ No I IF yes,attach copy to the report I I.rcense No Date of this report <br /> r-Z6 <br /> OWR 108 IREv s2-Stsi IF ADOMONAL SPACE 15 Nt_'EI720, USE NEXT CONSECUTIVELY NUMISERED FORM 96 96 6 <br />